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The two trials that proved a yearly low-dose CT scan cuts lung cancer deaths in heavy smokers.
NLST (NEJM 2011) showed a 20% relative reduction in lung cancer mortality with three annual low-dose CTs versus chest radiography. NELSON (NEJM 2020) showed a 24% reduction in men at 10 years with volume-based nodule management and a lower false-positive rate. Together they underpin USPSTF (age 50-80, ≥20 pack-years) and European screening recommendations. Uptake remains low.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
53,454 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| NLST: relative reduction in lung cancer mortalityprimary | Low-dose CT vs chest X-ray | - | 20% | - | - | link |
| NELSON: relative reduction in lung cancer mortality at 10 years (men)primary | Low-dose CT vs no screening | - | 24% | - | - | link |
Lung screening works when it uses volumetric nodule management, and it works against a no-screening control. The protocol underpins the UK Targeted Lung Health Check programme and European recommendations. Benefit in women remains less precisely estimated.
For people with a heavy smoking history, an annual low-dose CT scan is one of the few screening tests proven to reduce cancer deaths. Most abnormal scans are not cancer, so screening must be paired with careful nodule management. It does not apply to never-smokers or light smokers.
Shares NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms, NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers, Low-dose CT lung screening, Overdiagnosis and false alarms.
Shares UKLS, Low-dose CT lung screening, Resectable stage I to III non-small-cell lung cancer, Lung cancer (all types).
Shares UKLS, Low-dose CT lung screening, Lung cancer (all types), Non-small-cell lung cancer.
Shares NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms, NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers, Low-dose CT lung screening, The hardest cancers are found late.
Shares NHS Targeted Lung Health Check (lung cancer screening programme), Low-dose CT lung screening, CT (computed tomography), Lung cancer (all types).
Shares NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms, NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers, CT (computed tomography), The hardest cancers are found late.
Shares UKLS, Resectable stage I to III non-small-cell lung cancer, Lung cancer (all types), Non-small-cell lung cancer.
Shares UKLS, Low-dose CT lung screening, Lung cancer (all types), Non-small-cell lung cancer.